The petitioner Pramila Basak filed an application u/s.12 of the Consumer Protection Act 1986 for seeking relief which was registered as Consumer Case No.64/16 in this Forum.

The fact of the case as revealed from the petition is that the son of the complainant/petitioner Litan Basak, S/O. Shri Swapan Basak was the policy holder of LIC of India after depositing the premium of Rs.26,441 with proper proposal of deposit receipt issued by the O.P.No.1 on 30.04.14. But unfortunately the said Litan Basak died on 10.08.14. After the death of Litan Basak the petitioner/ complainant being the nominee and legal heir of deceased Litan Basak as he was unmarried submitted an application claiming the death benefit under the said policy on 18.08.14 with the office of O.P.No.2. From the evidence it is found that when the complainant/petitioner went to the office of O.P.No.2 and showed the receipt of premium at that time the O.P.No.2 stated the complainant that he would not get any death benefit as no policy certificate was issued in favour of Litan Basak. The further case of the complainant is that there was no latches and negligence on the part of Litan Basak as long before his death he paid the premium and O.P did not issue the policy certificate in favour of Litan Basak for which the complainant cannot suffer. After that the complainant sent legal notice through her Ld. Lawyer on 20.10.14 requesting the O.P to pay the death benefit of said Ltan Basak in respect of the policy to the complainant within 15 days from the date of receipt of notice otherwise the complainant  will have no other alternative but to move before the court of law for her redressal. Subsequently after receiving the notice the O.P.No.2 sent a reply dt.30.10.14 to the Ld. Advocate of the complainant stating that after going through the proposal the O.P came to know that the proponent is a handicapped person and O.P.No.2 forwarded the same to the Divisional Office at Jalpaiguri who is O.P.No.1 in this case and O.P.No.1 on 12.06.14 asked to submit the proposal along with some medical test and the said message was communicated to said Litan Basak and agent Shri Dinesh Kundu. The requirements as asked for were not submitted. So, the decision over the proposal is pending. The further case of the petitioner is that no message was sent to deceased Litan Basak and the agent Shri Dinesh Kundu never communicated anything. The further case is that  the O.P.No.2  illegally avoiding the payment of claim. The O.p negligently did not issue the policy certificate and due to the negligent act  of the O.P. the claimant not only subjected to financial loss but also subjected to mental pain and agony. The complainant has claimed Rs.10,00,000/- as death benefit of the deceased Litan Basak under the LIC policy for which the premium was paid on 30.04.14 and compensation of Rs.50,000/- for harassment and mental pain and agony and Rs.20,000/- as litigation cost. 

The petition has been contested by the O.Ps by filing the written version denying all the material allegations leveled against them contending inter alia that the case is not maintainable in the present form and law. The complainant has no, right, locus standi, prima facy case and cause of action to file the case. The case is barred by waiver, estoppels, acquiescence and limitation. The definite defence case is that Litan Basak proposed for an insurance policy of Rs.4,00,000/- under table/term 814/16 which was not converted into policy die to non submission of requirement. It is admitted that Litan Basak submitted a proposal for insurance coverage on his life at Kaliaganj Branch on 20.04.14 and deposited Rs.26,441/- as proposal deposit on 30.04.14. The further case is that on enquiry it was found that Litan Basak was physically handicapped person having deformity to the extent of 75% and the Kaliaganj Branch Office of LIC forwarded the proposal along with other papers to the Divisional Office, Jalpaiguri on 12.06.14 for necessary under writing decision. The further defence case is that on scrutiny of the proposal papers the Divisional office asked some requirements for medical reports which was communicated to Litan Basak by branch office on 16.06.14, but the said requirements were not submitted by the proposer and proposal for insurance was declined on 17.07.14 due to non submission of requirement which was also communicated to Litan Basak on 17.07.14. As there was no contract between Litan Basak and the O.Ps ,as such the claimant is not entitled to get any benefit under the policy. Moreover, the policy of Litan Basak was not at all accepted.

In order to prove the case the claimant Pramila Basak was examined as p.w.1. Swapan Kr. Basak the father of Litan Basak was examined as p.w.2. The complainant filed some documents by firisti which was all Xerox .

On the other hand on behalf of the O.P one Shri Bejoy Roy, Assistant Administrative Officer of Kaliaganj Branch was examined as O.P.W.1 and he was cross examined. No other witness was examined on behalf of the O.P.

                                      DECISION WITH REASONS

The Ld. Lawyer of the O.P reported citation of case law LIC Vs. Smt. Saraswati Devi of National Consumer Disputes Redressal Forum Rev. Petition No.2140 of 2013 and another case law  LIC Vs. Raja Vasireddy Komallavali Kamba & others reported in 1984 AIR 2014.

At the time of argument the Ld. Lawyer of the O.P vehemently argued that the claimant is not entitled to get any compensation as there was no policy between Litan Basak and the L.I.C. He further argued that mere submission of premium is not sufficient to hold that the proposal of the said deceased Litan Basak had accepted. Unless and until the proposal is accepted  the LIC is not liable to pay any compensation. In this regard the Ld. Lawyer for the O.P refers two case laws reported in National Consumer Disputes Redressal Forum Rev. Petition No.2140 of 2013, L.I.C Vs. Smt. Saraswati Devi in para 6 it has been held that mere receipt and retention of premium until after the death of the appellant or mere preparation of the policy document is not acceptance. And therefore, do not give rise to a contract. The general rule is that the contract  of insurance will be concluded only when the party to whom an offer has been made accepts it unconditionally and communicates his acceptance to the person making the offer whether the final acceptance is that of the assured or the insurers. This Forum is also same view of the case law submitted by the Ld. Lawyer for the O.P that mere receipt and payment of money does not give rise to a contract but in the same para it has been clearly stated that such fact depends on the way in which negotiations for any insurance have progressed.

Now, let us consider the evidence on record. From the evidence it is found that deceased Litan Basak deposited the premium of Rs.26,441/- on 30.04.14 and said Litan Basak died on 10.08.14. From the evidence it is also found that on 12.06.14 the Divisional Medical Officer asked some medical test. According to the defence case that matter was communicated to the deceased Litan Basak. But there is no record to show that such fact was communicated to Litan Basak. Moreover, from the cross examination of O.P.W.1 it has been clearly stated that there is no acknowledgement to show that Litan Basak received the letter which was issued on 17.07.14 by O.P.No.2. So, how the complainant will know about the repudiation of acceptance of proposal. Moreover, he further argued that payment was made on 10.04.14. Why there was delay to inform the matter on 17.07.14 though there is no record that the matter was informed to the petitioner. So, according to the case law final acceptance of proposal depends on the way of negotiations. As and when no intimation was received at all the death of Litan Basak on 10.08.14, it will be presumed that the proposal was duly accepted. Moreover, it is not understood why the authority like L.I.C will make an extraordinary delay for acceptance of proposal. The premium and proposal was made on 30.04.14 and as per defence case intimation was given on 17.07.14. It is not understood why such delay took place for such intimation. So, definitely there were latches on the part of L.I.C/O.P.

First it should be the general rule that the medical examination should be done before the payment of money towards policy. So, the general public will be in confusion that when he paid  money towards the premium it would be presumed that the policy has been concluded and the LIC should bring such notice to the general public at the time of making policy and such fact of policy should be intimated to the proposer that proposal has been accepted. For the instance case it is found that the LIC later on came to know that the deceased Litan Basak was suffering from 75% disablement. Before making of premium if the medical examination is concluded such question would not arise. So, the LIC in future to do this. This is the view of this Forum so that the general persons may not suffer in future. In this case the progress for negotiations of insurance was not at all satisfactory as because there was a long delay from the date of making of premium and date of communication as stated by the O.P. So, on considering the above two case laws submitted by the O.Ps, the view as expressed by the Hon’ble Supreme Court  and National Commission is not applicable in this instant case as because the progress of negotiations of insurance of the deceased was not at all satisfactory. So, on considering the facts and circumstances the Forum is in view that the complainant is entitled to get compensation.

Fees paid are correct.

Hence, it is

ORDERED,

That the instant consumer complaint being No. CC - 64/2016 be and the same is allowed on contest against the O.P but without any cost

 The complainant is entitled to get sum assured of Rs.4,00,000/-  plus all bonuses up to date is payable in a lump sum upon the life of the death assured as admissible. Besides that the complainant is entitled to get Rs.10,000/- as compensation towards mental pain and agony and Rs.5000/- as litigation cost   

The O.Ps/ insurance company are directed to make the payment as calculated above within one month from the date of passing of this order failing which it will carry interest at the rate of 5% per annum over the awarded amount from the date of filing i.e 12.09.2016 till the recovery. In the case of failure of payment, the petitioner/ complainant is at liberty to execute the order for recovery of the amount as per provision of law.

Let a copy of this order be given to the parties free of cost.